| NPI | 1063628691 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKIE RENEE RAMSEY Accountant 650-876-0866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 22546) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2020-08-22 |